Prevalence Estimates of ADHD in a Sample of Inpatients With Alcohol Dependence

Luderer, Mathias; Sick, Christian; Kaplan-Wickel, Nurcihan; Reinhard, Iris; Richter, Agnes; Kiefer, Falk; Weber, Tillmann

doi:10.1177/1087054717750272

Cited by 33 publications

(34 citation statements)

References 67 publications

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“…ADHD prevalence rates are higher in the AUD population than in the general population (Daigre et al, 2015;Luderer et al, 2018;Reyes et al, 2016;Roncero et al, 2019). Both ADHD and AUD have been associated with deficits in inhibitory control (Barkley, 1997;Herman & Duka, 2019;Pedersen Roberts et al, 2014;Smith et al, 2014;Wright et al, 2014).…”

Section: Discussionmentioning

confidence: 99%

“…The effectiveness of these treatments should be assessed in a sample of comorbid AUD and ADHD patients to determine whether they are equally effective in this subgroup as in AUD patients. Comorbid individuals tend to show an earlier onset of abuse, greater SUD comorbidity, as well as higher rates of substance abuse, suicide attempts, hospitalization, and depression (Arias et al, 2008;Huntley et al, 2012;Luderer et al, 2018). As stated by Huntley et al (2012), the comorbidity of SUD and ADHD is not only "a source of additional impairment to patients" but also represents "an increased burden on clinical services".…”

Section: Discussionmentioning

confidence: 99%

“…ADHD increases the risk for heavy substance use or developing a substance use disorder (SUD), particularly alcohol use disorder (AUD; Charach, Yeung, Climans, & Lillie, 2011;Estévez-Lamorte et al, 2019;Estévez et al, 2015;Lee, Humphreys, Flory, Liu, & Glass, 2011;Vogel et al, 2016;Wilens & Morrison, 2011). Within the AUD population, prevalence of adult ADHD ranges from 7.7% to 21.1%, with a rate of 20.5% in a German sample (Daigre et al, 2015;Luderer et al, 2018;Reyes et al, 2016;Roncero et al, 2019). The increased prevalence of ADHD in adults with AUD seems to be greatly attributable to ADHD individuals being more susceptible to early alcohol use, a persisting risky drinking behavior and is predictive of the maintenance of AUD in later life (Charach et al, 2011;Estévez-Lamorte et al, 2019;Estévez et al, 2015;Lee et al, 2011;Wilens & Morrison, 2011).…”

Section: Introductionmentioning

confidence: 99%

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Interaction between behavioral inhibition and neural alcohol cue-reactivity in ADHD and alcohol use disorder

et al. 2020

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Rationale Compared to the general population, adult Attention-Deficit / Hyperactivity Disorder (ADHD) is more prevalent in patients with Alcohol Use Disorder (AUD). Impaired behavioral inhibition is a common characteristic in both ADHD and AUD. Relapse risk is increased in patients with AUD and comorbid, untreated ADHD and in AUD patients with increased neural cuereactivity. Objectives In this study, we examined the interaction between neural correlates of behavioral inhibition and alcohol cuereactivity with a hybrid imaging task. Methods Out of 69 adult study participants, we included n = 49 in our final analyses: Individuals had a diagnosis of either AUD (n = 13), ADHD (n = 14) or both (n = 5), or were healthy controls (HC; n = 17). The functional magnetic resonance imaging paradigm aimed to examine the combined effects of both an interference-inhibition task ("Simon-task") and an alcohol cuereactivity task. Instead of segregating by diagnostic group, we pursued a dimensional approach in which we compared measures of AUD and ADHD severity, as well as the interaction of both, using multiple regression analyses. Results The four groups did not differ on the behavioral level on either the inhibition task or the alcohol cue-reactivity task. However, brain activation in frontal control and reward-related regions during completion of the combined tasks were related to ADHD and AUD severity (symptom load). During presentation of both alcohol cues and the inhibition task, participants with higher AUD and ADHD symptom load exhibited greater BOLD (blood oxygen level dependent) responses in subcortical reward-related regions. Conclusions Our findings support the hypothesis that ADHD additionally diminishes inhibition ability in individuals with AUD. This may increase relapse risk when confronted with alcohol cues. Further, it is crucial for patients with comorbid AUD and ADHD to take into account not only reduced cognitive control over behavioral inhibition but also simultaneously heightened alcohol cue-reactivity.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Interaction between behavioral inhibition and neural alcohol cue-reactivity in ADHD and alcohol use disorder

et al. 2020

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“…As previously reported [8], patients with AD according to ICD-10 were assessed for ADHD during long-term residential treat-ment in the addiction treatment center MEDIAN Klinik Wilhelmsheim, Germany. ADHD assessment was initiated following several weeks of controlled sobriety and was based on a 2-stepped procedure.…”

Section: Participants and Diagnostic Assessment Of Adhdmentioning

confidence: 99%

“…Patients with psychiatric disorders often suffer from undetected or untreated ADHD [6]. This is also true for patients with substance use disorders (SUDs) in which ADHD is highly frequent (10-20%) but also frequently overlooked [7][8][9] which makes routine screening for ADHD essential in addiction treatment [7,10]. If comorbid ADHD is present in patients with SUDs, additional psychiatric comorbidities are more the rule than the exception which complicates diagnostic assessment and worsens prognosis.…”

Section: Introductionmentioning

confidence: 99%

ADHD Is Associated with a Higher Risk for Traumatic Events, Self-Reported PTSD, and a Higher Severity of PTSD Symptoms in Alcohol-Dependent Patients

Luderer

Reinhard

Richter³

et al. 2020

Eur Addict Res

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Introduction: Alcohol dependence (AD) is frequently associated with attention-deficit/hyperactivity disorder (ADHD) as well as with posttraumatic stress disorder (PTSD). Objective: Aim of this study was to investigate whether in patients with AD, ADHD is associated with an increased rate of exposure to potentially traumatic events (PTEs) and PTSD, with increased PTSD severity and higher impact on daily functioning. Methods: Patients with AD were thoroughly assessed for ADHD during long-term residential treatment. Participants also completed the Posttraumatic Diagnostic Scale (PDS). The PDS is a 49-item self-report instrument that assesses exposure to different PTEs, DSM-IV criteria for PTSD, severity of PTSD, and related functional impairment. Results: Of 341 patients with AD, 66 were diagnosed with ADHD (19%). ADHD was associated with a more frequent exposure to PTEs (88 vs. 65%, p < 0.001). In patients with PTEs (n = 237), odds for PTSD were higher in ADHD versus no-ADHD patients (OR 8.9, 95% CI 3.9-20.5). Furthermore, PTSD severity and functional impairment were increased in ADHD patients. Conclusions: ADHD in patients with AD is associated with a higher frequency of PTEs and PTSD with more severe and more impairing PTSD symptoms. In alcohol-dependent patients with ADHD, regular screening for PTSD should be considered.

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ADHS im Erwachsenenalter und substanzbezogene Störungen

Schecke

Mette

2020

Handbuch Klinische Psychologie

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Prevalence Estimates of ADHD in a Sample of Inpatients With Alcohol Dependence

Abstract: This study provides the largest sample on ADHD prevalence in alcohol dependent inpatients. Despite great efforts to avoid overestimation, we found every fifth patient to have ADHD. ADHD diagnosis should not be based solely on a structured interview but should be clinically confirmed.

Cited by 33 publications

References 67 publications

Interaction between behavioral inhibition and neural alcohol cue-reactivity in ADHD and alcohol use disorder

Interaction between behavioral inhibition and neural alcohol cue-reactivity in ADHD and alcohol use disorder

ADHD Is Associated with a Higher Risk for Traumatic Events, Self-Reported PTSD, and a Higher Severity of PTSD Symptoms in Alcohol-Dependent Patients

ADHS im Erwachsenenalter und substanzbezogene Störungen

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